Why Do Physicians Prescribe Stress Ulcer Prophylaxis to Hospitalized General Medicine Patients?

1Baystate Medical Center, Springfield, MA
2Baystate Medical Center, Springfield, MA
3Baystate Medical Center Springfield, MA
4Baystate Medical Center, Springfield, MA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 140

Background:

Although multiple studies have shown that inappropriate use of stress ulcer prophylaxis (SUP) is common for non‐intensive care unit (ICU) hospitalized patients, little is known about why physicians prescribe SUP without supporting evidence. This study seeks to understand which factors influence physician prescribing behavior regarding SUP.

Methods:

We designed a cross sectional Web‐based survey to assess physicians knowledge, beliefs, and behavior surrounding prescribing of SUP for non‐ICU patients. The 24‐question survey was emailed to 150 internal medicine residents and hospitalists at a university‐affiliated tertiary‐care hospital. Clinically relevant bivariable associations were examined in logistic regression to determine whether these associations remained after adjustment for potential confounding factors.

Results:

Sixty‐nine percent of physicians reported prescribing SUP to ≥ 25% of patients. In multivariable analyses, the following factors were associated with higher level of prescribing (≥ 25%) of SUP: fear of gastrointestinal bleeding (OR = 2.7, 95% C1 1.07, 7.28) and of the legal repercussions of not prescribing SUP (OR = 3.02, 95% Cl 1.07, 8.56 ), whereas knowledge of SUP indications (OR = 0.39, 95% Cl 0.20, 0.74) and concern about side effects (OR = 0.24, 95% Cl 0.09, 0.61) were associated with low prescribing behavior. Level of training was not associated with prescribing rate. In addition, fewer than half of respondents were able to identify a single side effect of proton pump inhibitor therapy.

Conclusions:

Fear of legal repercussions and ignorance of the side effects of acid suppressive therapy were strongly associated with inappropriate prescribing of SUP. Educating physicians about the adverse effects of acid suppression therapy and about existing national guidelines might reduce inappropriate prescribing.

Author Disclosure:

S. Hussain, Baystate Medical Center, employment; M. Stefan, Baystate Medical Center, employment; P. Visintainer, Baystate Medical Center, employment; M. Rothberg, Baystate Medical Center, employment.

To cite this abstract:

Stefan M, Hussain S, Visintainer P, Rothberg M. Why Do Physicians Prescribe Stress Ulcer Prophylaxis to Hospitalized General Medicine Patients?. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 140. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/why-do-physicians-prescribe-stress-ulcer-prophylaxis-to-hospitalized-general-medicine-patients/. Accessed July 24, 2019.

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